Adding a trim button to the tiller?

I just picked up a powrtran tilt unit (kinda like a cmc). It has a giant dual button for the controls. Is there a way I can modify my tiller to change the throttle with one that has the thumb control for the trim?

Your options are only limited by your imagination, provided you are using a power relay and not relying on your switch to carry all the current. Any switch capable of carrying the current directly is going to be large.
I am currently looking at rigging a thumb switch that mounts in the end of my tiller tube, biggest concern is getting something that is IP67 certified so water doesn't kill it.
Right now I'm running a simple DPST toggle switch with momentary ON-OFF-ON contacts strapped to my tiller with band clamps.

Cleavage - the only thing you can look down on and still approve of.

During duck season, cleanliness isn't next to Godliness, it's next to impossible.

I had a CMC on a 40 Tohatsu that I ran the switch to the end of the tiller, but I didn't like it there as much as I thought I would. Mainly because the switch twisted with the throttle and sometimes in the heat of battle I would fail to keep up with the orientation of the switch since it changed as the throttle turned. I moved the switch to the grab bar and ran it with my right hand and that was much preferred by me.

I had a CMC on a 40 Tohatsu that I ran the switch to the end of the tiller, but I didn't like it there as much as I thought I would. Mainly because the switch twisted with the throttle and sometimes in the heat of battle I would fail to keep up with the orientation of the switch since it changed as the throttle turned. I moved the switch to the grab bar and ran it with my right hand and that was much preferred by me.

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Same here. ^^^^
I had a Panther unit on my boat. I tried but didn't like the switch on the tiller so I mounted it where I could use with my other hand.